Golden View Health Care Center Benefit Guide 2019

1. 2019 BENEFIT GUIDE

2. Introduction • As an employee of Golden View Health Care Center, the benefits available to you represent a significant component of your compensation package. They also provide important protection for you and your family in the case of illness or injury. This Guide will help you understand what is available to you and how to enroll in the many benefits Golden View has to offer in order to maximize your total compensation package.

3. BenefitsOverview • Medical & Rx • Cigna • Health Savings Account • Tax-advantaged savings accounts for employees enrolled in the high deductible health plan • Flexible Spending Account • Tax-advantaged Dependent Care • Tax-advantaged Medical Savings Account • Health Reimbursement Account • Golden View reimburses employee for the out-of-pocket deductible For Rx on HMO Up to $250.00 • Dentaland STD • The Standard • Life/AD & D, Vol Life • Mutual of Omaha • 403B Pre-Tax Retirement • The Bank of New Hampshire

4. Benefit Highlights • Golden View provides Medical, Dental, Life, AD&D, Voluntary Life, Short Term Disability, Health Savings Account, Health Reimbursement Account, Flexible Spending Account, Dependent Care Account and a 403b Retirement Plan. • Golden View provides team & personal development programs, personal & family benefits and many extras that make our workplace one of the best places work.

5. Coming together, sharing together, working together, succeeding together At Golden View working together serving the needs of those entrusted to our care is something we take very seriously. While we are focused on our tasks and immersed in our work we share a great deal. Working to achieve our common goals makes us a family of sorts. Golden View provides many extras and programs designed to reward our employees and makes us one of the best places to work.

6. The Little Things • Annual and monthly staff recognition awards • Employee of the year award, recognition & cash • Anniversary BBQ • Birthday & Anniversary cards • Raffles, giveaways • Flowers (illness, loss, milestones) • Free coffee/tea • Holiday gift cards, parties, Secret Santa • BJs membership • Free parking

7. Team and Personal Development • Customer Service Training • Leadership Development Programs • Enrichment Programs, CPR Certification • Dementia Training Program • Annual Retraining days with lunch • Education Reimbursement • Clinical Site/Education Partnerships • Ongoing seminars and training • Career advancement Opportunities • Personal/education leave programs

8. Personal & Family Benefits • Free vaccines (Flu, Hepatitis B) • Company paid disability & life • Health insurance (employer contribution) • Dental insurance • Roll over vacation time (no “use it or lose it”) • Flexible Spending Accounts for pre- tax dependent/health expenses • Post job offer company paid health screening • Multicultural company • Flexible scheduling options

9. Health Plan Options • Choosing a health coverage option is an important decision. To help you make an informed choice, a Summary of Benefits and Coverage (SBC), which summarizes important information about health coverage options is available to help you compare the plans Golden View offers. • Golden View offers 2 plans for you to choose from with Cigna. You may choose between a Copay or HSA plan. • You are eligible for health benefits after a 90 day waiting period unless otherwise eligible.

10. Health Plan Summaries

11. Golden View Health Care Center Employee Medical Cost

12. How to Find a Provider How to find a Cigna provider: 1. Go to www.cigna.org and under Top Tasks.. 2. select “find a doctor.” 3. Under not a Cigna customer yet select “plans through your employer” 4. Under medical plans select “Open Access Plus” 5. If searching by provider type, you can narrow your search by: • Using your ZIP code to find providers near you • Selecting a certain specialty • Choosing only providers accepting new patients • Indicating your preferred provider gender • Selecting providers who speak additional languages • Selecting providers with admitting privileges at specific hospitals or affiliated with certain provider groups

13. What is Preventive Care • Annual physical exams and cancer screenings • Take advantage of the fact the Medical plan covers 100% of scheduled annual physical exams and cancer screening tests related to the physical exam when you use an in-network provider. There is no copay or deductible, however keep in mind that if your physician orders a test that isn’t part of the scheduled preventive care exam/test, those procedures may be subject to a copay or deductible. It’s always a good idea to check with your doctor’s office before your visit, to see what tests or exams are planned. Then, call your health plan to make sure you understand if and how those tests will be covered • Preventive Dental Care • Your dental plan is designed to provide the dental coverage you need with the features you want. Take advantage of what this plan has to offer without compromising what matters most - including the freedom to visit the dentist of you and your dependents choice – an “in-network” dentist or an “out-of-network” dentist. Don’t forget that your preventive care – is covered at 100% twice per calendar year.

14. Get More Value from Your Plans • For Life Threatening Emergencies • In a true medical emergency – such as an apparent heart attack, serious injury, or other life-threatening situation – always call 911 or your local emergency number right away! • For less critical issues, if the emergency is NOT life threatening: • Call your primary care physicians office (even after hours, someone is typically on call to answer questions). Your doctor will know you and your medical history and may be able to schedule you for a visit the same (or next) day. • If your condition starts or worsens on the weekend, or after your doctor’s office has closed for the day, you may want to consider a visit to an Urgent Care facility such as Clear Choice M.D. in Belmont, NH. These clinics are not affiliated with hospitals, but they do have doctors and nurses on staff and are open in the evenings and on weekends. • If you are travelling and you need Urgent Care • Your medical plan covers urgent care. An urgent condition is one that requires immediate care, but isn’t life-threatening. If you seek urgent care while traveling, you or someone acting on your behalf should notify your doctor within 48 hours of the onset of the urgent condition.

15. Physician’s office submits claim for $150 to insurance company. Member goes to the doctor for a Sinus Infection and presents the Medical Insurance ID card. Physician treats member. The member does not pay at the time of service. You will be billed at a later date. Insurer receives claim and adjusts amount owed based on Insurer’s contracted rates with that provider. Insurer applies the $80 toward the member’s annual deductible Physician sends member a bill for $80. Member pays physician $80 (member can use H.S.A. bank account for this) Insurer sends the member and provider office an EOB (explanation of benefits) stating member owes $80. How is a medical claim processed in the HDHP?

16. Health Savings Account • Health Savings Accounts are tax-advantaged savings accounts that are available to employees who are enrolled in the high deductible health plan. In addition to being enrolled in a High Deductible Health Plan you must not be enrolled in Medicare, have any other coverage or be listed as a dependent on someone else’s tax return. The account is employee-owned. If the employee leaves the company, he or she owns the account and remains in control of the funds. The account is portable, and you may continue to make deposits into the account as long as you are enrolled in an Health Savings Account compliant High Deductible Health Plan. • You can open an Health Savings Account at your bank, credit union or other authorized financial institution. You will need to provide proof of id, your social security number and proof of your high deductible health plan. • You can fund your account however you want to: all at once, monthly or as needed. The funds contributed to the account are pre-tax, which means they aren't subject to federal income tax. You may deduct “off the top” from your adjusted gross income the total amount contributed to your Health Savings Account for that year. Funds must be used to pay for qualified medical expenses; there is a heavy tax penalty for paying for non-qualified expenses. Funds roll over year after year if you don't spend them, and can accumulate a significant balance. There is a limit to how much money can be put into an Health Savings Account every year, but no cap on how much money can be in the account. The limits for 2019 are $3,500 for an individual and $7,000 for a family plan.

17. Health Savings Account Frequently Asked Questions How do I get reimbursed? • You can use your Health Savings Account to pay deductible expenses, any applicable coinsurance, and other qualified health care expenses. You will receive a debit card so that you can pay for services as you receive them, or you can file a claim to get reimbursed. What happens to any money I don’t use in 2018? • Your Health Savings Account funds will rollover, year after year. They belong to you, even after you leave employment. Can I add my own pre-tax dollars to the Health Savings Account? • Yes, between you and your employer, contributions of up to $3,450 in 2017 for individual coverage, or $6,900 for family coverage are allowed into the HSA. If you are over age 55, you can contribute an additional $1,000 in 2018 as a “catch-up” contribution. If I leave employment, what happens to my Health Savings Account? • Your Health Savings Account is portable, so if you leave employment for any reason, your Health Savings Account goes with you. Can I withdraw money from a Health Savings Account for non-qualified expenses? • Yes, but if you withdraw funds for non-qualified expenses before you turn 65, you have to pay taxes on the money and a 20% penalty. If you take money out after you turn 65, you don't have a penalty, but you must still pay ordinary income taxes on the money you withdraw for non-qualified expenses.

18. Flexible Spending Account • Employees have the opportunity to participate in a healthcare flexible spending account and dependent care accounts. This valuable benefit allows you to save money on a pre-tax basis to pay for eligible medical and dependent care expenses. You will not have to pay Federal, State or FICA taxes on any amount you contribute to these accounts. This can save you up to 20-30% on these expenses. The annual maximum contribution is $2,650 for the medical FSA and $5,000 for the Dependent care account. • Please see HR for a brochure on this program as well as a list of other eligible expenses under the plan.

19. Dental – Standard PPO Plan • Annual Maximum: $1,000 per member • Deductible: $50 Single / $150 Family max, waived for preventive • Preventive Services: 100% In-Network & Out-of-Network • Routine exams (One every 6 months) • Teeth cleaning (One every 6 months) • Fluoride treatment (one per calendar year for children under age 14) • Basic Services: 80% In-Network & 80% Out-of-Network • Fillings & Stainless Steel Crowns • Simple Oral Surgery • Root Canal Therapy • Major Services: 50% In-Network & 50% Out-of-Network • Crowns, Bridges and Dentures • Orthodontia Services: Not Covered

20. Dental – Standard PPO Plan Additional Vision Benefit with Policy Link • Effective 06/01/2018 • $150 of Vision Coverage: All Vision Providers • Can be used towards: • Vision Exam • Lens and Frames • Lenses and lenses fittings • This $150 will be deducted for the overall Dental Annual Maximum of $1,000

21. Standard Dental Benefits

22. Golden View Employee Voluntary Dental Cost

23. Life Insurance – Mutual of Omaha • Employee Coverage Only. Coverage is 100% paid for by Golden View for all full-time employees. You must complete a Beneficiary Form. • All full time employees will receive a $10,000 benefit unless otherwise eligible. • Age Reduction Schedule • Age 65-69: 65% of original amount • Age 70 and over: 50% of original amount • Please be sure your beneficiary form is current. • Forms are available in HR.

24. Voluntary Life Insurance– Mutual of Omaha • Employees may purchase Voluntary Life Insurance for themselves, their spouse and their children. • Employee coverage is in increments of $10,000, not to exceed $300,000 or 5x employee salary. • Spouse coverage can not exceed 50% of the employee volume • Child(ren) coverage is $250 (age 14 days to 6 months), $10,000 (age 6 months to 19/25). • Coverage may be purchased up to the guaranteed issue amount without evidence of insurability at the time you are hired. Guaranteed issue is $150,000 for employee and $30,000 for spouse. • If you choose to purchase coverage at a later date you will be required to provide Evidence of Insurability (proof of good health). • This voluntary benefit is 100% employee paid.

25. Income Protection Benefits- Standard • Short Term Disability • The elimination period is 0 days for accidents and 7 days for illness, surgery, pregnancy then the plan pays 60% of your base weekly salary to a maximum of $500 per week up to 26 weeks. • Coverage is 100% paid for by Golden View for all full time employees. No action is required on your part for enrollment.

26. 403B Retirement Plan • All current employees are eligible to participate in the elective deferral portion of the plan. • There is no waiting period. Eligible employees may join the elective deferral portion of the Plan on their date of hire. • The plan provides for discretionary matching contributions on elective deferrals in the amount to be determined by the company on an annual basis. This is a brief overview of the plan. Please refer to the Summary Plan description for full details.

27. Benefit Resource Center • USI’s benefit information hotline to act as a single point of contact for all benefit questions and claim issues. • Answer benefit plan/policy questions • Assist with eligibility and claim problems with carriers • Provide claim appeals information and explain the process • Hours are 8:00 am to 5:00 pm Monday through Friday, and the telephone number is 855-USI-6699 or you may email the BRC at BRCEast@usi.com.

28. Required Forms • Employee Acknowledgement Form (including waivers) • Cigna Enrollment Form • Only employees making changes or coming on for the first time • Standard Dental Enrollment Form • Only employees making changes or coming on for the first time. • Mutual of Omaha Life Enrollment Form • Only employees making changes or coming on for the first time • Health Savings Account • All new participants will need to open a Health Savings Account in order to receive the contribution from Golden View. • Flex Benefit Form • 403B Enrollment Form

29. REMINDERS • You must complete enrollment forms and submit to HR. • Coverages to be effective after a 90 day waiting period unless otherwise eligible.